NPI | 1972506616 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA 20A-8534) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A8534) |
207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 005389) | |
207Q00000X Family Medicine (Licence: CA 20A8534) | |
207QA0401X Family Medicine, Addiction Medicine (Licence: AZ 5389) | |
2083A0300X Preventive Medicine, Addiction Medicine (Licence: AZ 5389) | |
2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA 20A-8534) | |
Enumeration Date | 2005-05-25 |
Last Update Date | 2022-12-13 |